Artificial Sweeteners - Not That Sweet
When a person goes grocery shopping, chances are they will come across a product that has “0g sugar/low sugar” labelled on it. The increasing number of cases of diabetes worldwide provides corporations the perfect opportunity to create products aimed at the management of diabetes. With an abundance of products committed to ditch “good ol’ sugar”, companies tend to use artificial sweeteners as a substitute to maintain a level of sweetness in their products. Even though having little to no sugar in processed foods may be beneficial for a diabetic individual, the unfortunate truth is that artificial sweeteners have the potential to cause harmful long-term effects. For example, stroke, dementia, type 2 diabetes, glucose intolerance, and addiction to artificial sweeteners may be potential side-effects to artificial sweeteners. It’s crucial for people living with diabetes to be aware of the foods they buy and not get tricked by corporations into buying potentially harmful products (Sharma et al., 2016).
Diet drinks are well known to be marketed to have no sugar. A study examined the diet of 3,000 adults over the span of 10 years and recorded the incidence of stroke and dementia that occured in that time frame. The findings were highly concerning. It turns out that adults that consumed diet drinks experienced 3 times more strokes and were 3 times more likely to be diagnosed with dementia in comparison to adults that did not consume diet drinks (Pase et al., 2017). These findings demonstrate that the consumption of a sugar-free product (e.g., diet coke) may be linked to life threatening consequences.
Consumption of artificial sweeteners has also shown a correlation with the development of type 2 diabetes and glucose intolerance. A review study found that regular consumption of diet soda led to a 67% greater risk of developing type 2 diabetes in comparison to people who did not consume diet soda regularly (Nettleton et al., 2009). Furthermore, a study which involved injecting mice with an artificial sweetener (Saccharin) for 11 weeks found that the mice developed glucose intolerance (Suez et al., 2014). Glucose intolerance is a metabolic condition that leads to increased blood glucose levels, resulting in individuals becoming prediabetic or diabetic. These studies suggest that replacing sugars with artificial sweeteners may be ineffective in avoiding diseases like diabetes.
One of the neurological consequences of consuming foods with artificial sweeteners is the risk of developing an addiction for them. A study conducted on rats showed that rats may prefer saccharin over highly addictive substances such as cocaine (Lenoir et al., 2007). Their preference for artificial sweeteners demonstrates the potential for people to be addicted to food that contains these products. Dr. Ludwig (an obesity and weight loss specialist) states that people who are addicted to artificial sweeteners find healthy foods such as fruits and vegetables ‘unappealing’ or ‘unpalatable’ (Strawbridge, 2012). This can be alarming because not only does being addicted to artificial sweeteners increase the risk of developing disease but it also deters people away from consuming nutritional foods essential for the human body.
Despite the evidence that many artificial sweeteners can be harmful, there are FDA approved sweeteners that can be a healthy alternative to sugar. Stevia is a popular natural sweetener extracted from the plant Stevia rebaudiana. It can be up to 350 times sweeter than sugar. Stevioside is a compound linked to health benefits such as lower blood pressure and controlled blood sugar levels (Samuel et al., 2018). Monk fruit sweetener is another sweetener which is extracted from the monk fruit plant and is deemed to be a safe and healthy alternative to sugar and acts as an antioxidant (Xu et al., 2013). Sugar alcohol (xylitol), which is extracted from corn and birch wood, does not raise blood or insulin levels and is actually linked to an improvement in dental and bone health (Salli et al., 2019). Similarly, the sugar alcohol erythritol is a substitute that tastes very similar to sugar and does not raise glucose or insulin levels (Regnat, Mach, Mach-Aigner., 2018). However, the long term effects of the sugar alcohols xylitol and erythritol remain inconclusive and more research must be conducted. That being said, well known sweeteners such as honey, maple syrup, coconut sugars, and molasses are also great alternatives to white sugar, and can be incorporated in many different ways into one’s diet.
It is tough to win in this situation, regardless of whether someone has diabetes or not. We are advised to avoid food with sugar, but also not to have sugar-free food as they may be artificially sweetened. The best way to go about this situation is to consume foods (with or without artificial sweeteners) in moderation. Consuming sweet foods in moderation is a much healthier alternative than regular consumption of artificial sweeteners.
References:
Lenoir, M., Serre, F., Cantin, L., & Ahmed, S. H. (2007). Intense sweetness surpasses cocaine reward. PloS one, 2(8), e698.
Nettleton, J. A., Lutsey, P. L., Wang, Y., Lima, J. A., Michos, E. D., & Jacobs, D. R. (2009). Diet soda intake and risk of incident metabolic syndrome and type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA). Diabetes care, 32(4), 688-694.
Pase, M. P., Himali, J. J., Beiser, A. S., Aparicio, H. J., Satizabal, C. L., Vasan, R. S., ... & Jacques, P. F. (2017). Sugar-and artificially sweetened beverages and the risks of incident stroke and dementia: a prospective cohort study. Stroke, 48(5), 1139-1146.
Regnat, K., Mach, R. L., & Mach-Aigner, A. R. (2018). Erythritol as sweetener-wherefrom and whereto?. Applied microbiology and biotechnology, 102(2), 587–595. https://doi.org/10.1007/s00253-017-8654-1
Salli, K., Lehtinen, M. J., Tiihonen, K., & Ouwehand, A. C. (2019). Xylitol's Health Benefits beyond Dental Health: A Comprehensive Review. Nutrients, 11(8), 1813. https://doi.org/10.3390/nu11081813
Samuel, P., Ayoob, K. T., Magnuson, B. A., Wölwer-Rieck, U., Jeppesen, P. B., Rogers, P. J., Rowland, I., & Mathews, R. (2018). Stevia Leaf to Stevia Sweetener: Exploring Its Science, Benefits, and Future Potential. The Journal of nutrition, 148(7), 1186S–1205S. https://doi.org/10.1093/jn/nxy102
Sharma, A., Amarnath, S., Thulasimani, M., & Ramaswamy, S. (2016). Artificial sweeteners as a sugar substitute: Are they really safe?. Indian journal of pharmacology, 48(3), 237.
Strawbridge, H. (2012). Artificial sweeteners: sugar-free, but at what cost?. Harvard Health Blog.
Suez, J., Korem, T., Zeevi, D., Zilberman-Schapira, G., Thaiss, C. A., Maza, O., ... & Kuperman, Y. (2014). Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature, 514(7521), 181-186.
Xu, Q., Chen, S. Y., Deng, L. D., Feng, L. P., Huang, L. Z., & Yu, R. R. (2013). Antioxidant effect of mogrosides against oxidative stress induced by palmitic acid in mouse insulinoma NIT-1 cells. Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas, 46(11), 949–955. https://doi.org/10.1590/1414-431X20133163